Background

The effects of different autograft types for anterior cruciate ligament reconstruction (ACL-R) on muscle function are sparsely investigated in randomized controlled trials. Our aim was to investigate the effects of quadriceps tendon autograft (QTB) vs. semitendinosus-gracilis autograft (StG) on thigh muscle strength and functional capacity, and a patient-reported outcome 1 year after ACL-R, and to compare the results to healthy controls.

Methods

ACL-R patients (n = 100) and matched controls (CON, n = 50) were recruited, with patients being randomly assigned to QTB (n = 50) or StG (n = 50) ACL-R. One year after ACL-R, bilateral knee extensor (KE) and flexor (KF) muscle strength (isometric, dynamic, explosive, limb symmetry index [LSI], hamstring:quadriceps ratio [HQ ratio]) were assessed by isokinetic dynamometry, along with functional capacity (single leg hop distance [SHD]) and a patient-reported outcome (International Knee Documentation Committee [IKDC] score).

Results

KE muscle strength of the operated leg was lower (9–11%) in QTB vs. StG as was KE LSI, while KF muscle strength was lower (12–17%) in StG vs. QTB as was KF LSI. HQ ratios were lower in StG vs. QTB. Compared with the controls, KE and KF muscle strength were lower in StG (10–22%), while KE muscle strength only was lower in QTB (16–25%). Muscle strength in the StG, QTB, and CON groups was identical in the non-operated leg. While SHD and IKDC did not differ between StG and QTB, SHD in both StG and QTB was lower than CON. The IKDC scores improved significantly 1 year following ACL-R for both graft types.

Conclusion

One year after ACL-R, muscle strength is affected by autograft type, with StG leading to impairments of KE and KF muscle strength, while QTB results in more pronounced impairments of KE only. Functional capacity and patient-reported outcome were unaffected by autograft type, with the former showing impairment compared to healthy controls.

Clinical Trials Registration Number

NCT02173483.

中文翻译：

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自体移植物类型对前交叉韧带重建患者肌肉力量和功能能力的影响：一项随机对照试验。

背景

在随机对照试验中很少研究用于前交叉韧带重建 (ACL-R) 的不同自体移植物类型对肌肉功能的影响。我们的目的是研究自体股四头肌腱（QTB）与自体股薄肌腱（StG）对大腿肌肉力量和功能能力的影响，以及 ACL-R 后 1 年患者报告的结果，并将结果与健康的对照。

方法

招募了ACL-R 患者 ( n  = 100) 和匹配的对照 (CON, n  = 50)，患者被随机分配到 QTB ( n  = 50) 或 StG ( n  = 50) ACL-R。ACL-R 一年后，通过等速测力法评估双侧膝关节伸肌 (KE) 和屈肌 (KF) 肌肉力量（等长、动态、爆发力、肢体对称指数 [LSI]、腘绳肌：股四头肌比 [HQ 比]），以及具有功能能力（单腿跳跃距离 [SHD]）和患者报告的结果（国际膝关节文献委员会 [IKDC] 评分）。

结果

QTB 与 StG 和 KE LSI 手术腿的 KE 肌力较低（9-11%），而 StG 与 QTB 的 KF 肌力较低（12-17%），KF LSI 也是如此。StG 与 QTB 的总部比率较低。与对照组相比，StG 组的 KE 和 KF 肌力较低（10-22%），而 QTB 组的 KE 肌力仅较低（16-25%）。StG、QTB 和 CON 组的肌肉力量在非手术腿中是相同的。虽然 SHD 和 IKDC 在 StG 和 QTB 之间没有差异，但 StG 和 QTB 的 SHD 均低于 CON。两种移植物类型的 ACL-R 后 1 年 IKDC 评分显着提高。

结论

ACL-R 一年后，肌力受自体移植类型的影响，StG 导致 KE 和 KF 肌力受损，而 QTB 仅导致更明显的 KE 受损。功能能力和患者报告的结果不受自体移植类型的影响，与健康对照相比，前者显示出损伤。

临床试验注册号

NCT02173483。